| NW 88326 |
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Assassination Records Review Board
Final Determination Notification

AGENCY : HSCA
RECORD NUMBER : 180-10071-10001
RECORD SERIES : STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :

December 8, 1995
Status of Document: Postponed in Part

Number of releases of previously postponed information: 12

Reason for Board Action: The Review Board's decision was premised on several factors
including: (a) the significant historical interest in the document in question; (b) the
absence of evidence that the release of the information would cause harm to the United
States or to any individual. -

Number of Postponements: 11

Postponements: All the postponements in this document represent Social Security numbers.

Reason for Board Action: The text is redacted because the public disclosure of the redaction could
reasonably be expected to constitute an unwarranted invasion of personal privacy, and that invasion of
privacy would be so substantial that it outweighs the public interest.

Substitute Language: SSN

Date of Next Review: 2017

Board Review Completed: 10/24/95


Bw eg Date: 08/20/93
Page:1
JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA
RECORD NUMBER : 180-10071-10001

RECORDS SERIES :
STAFF PAYROLL RECORDS

DOCUMENT INFORMATION

ORIGINATOR :
FROM :
TO :

HSCA

TITLE ;

DATE
PAGES

12/01/76
12

SUBJECTS
HSCA, ADMINISTRATION
PURDY, DONALD

DOCUMENT TYPE PRINTED FORM -

CLASSIFICATION : U
RESTRICTIONS : 3
CURRENT STATUS. : P

DATE OF LAST REVIEW : 06/03/93

OPENING CRITERIA

COMMENTS

Box 2.

[R] - ITEM IS RESTRICTED

| NW 88326
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PAYROLL AUTHORIZATION FORM “

. ; fn Fae on this form must be initialed by the
or Ballpoint Pen) = Washington, D.C. 20515 authorizing official.)

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action:

| Employee Name (First-Middle-Last)
Donald A. Purdy, Jr. December 1, 1978

Employee Social Security Number Type of Action ;

214~38-9707 |

. Employing Office or Committee/Subcommittee

Assassinations

O Appointment
& Salary Adjustment ,

O Title Change

C Termination (At close of business on effective date)

( Leave without pay (Beginning with effective date above and ending

close of business... = )
Specify Date ,

(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below.) |

Position Title — Gross Annual Salary *

$43,000.09 —

plus the salary received from the employing office.

(If Committee Employee, complete appropriate item below.)
1. O Standing Committee: Staff—O] Clerical or 0 Professional.

-2E2__of == 22 Congress.
3. 0 Joint Committee. -

(If Employee of an Officer of the House, complete item below.)

Position Number___.... __——-_—if applicable, Level________ Step...

| certify that this authorization is not in violation. of 5 U.S.C. 3110(b), prohibiting the employment of
relatives. ; . ee

2 an 3 4 fe a “eo ag age
Date_ becemper 11 eee , 1929 we ete
a ic “ (Signature of Authorizing Official)
Noe LOUIS STOKES.
(lf appropriate, signature of Subcommittee Chairman or Ranking Minority Member). Type or print name of Authorizing Official) ~SSOSCt*C~C<CS;S~SCS
Chairman
~~ "(ype or print name ond title of above official), =SOStSCS*~CS~S~S ee Title “if Member, Diswictand tote) ~

All appointments and salary adjustments for employees under the House Classification Act and for Committee em-
ployees, except those of the Committee on Appropriations, the Committee on the Budget, and the Joint Committees, must
be approved by the Committee on House Administration. - ‘

APPROVED: ,

| Office of Finance use only: : ID.
Office Code alte . Benefits _________._-.._______
Monthly Annuity $______.___-00 as of Loe -e eee a _ Payroll_____ Woo !

- +.» Copy: for. Initiating Office or Committee -

(Please Use Typewriter C) US. HOUSE OF REPRESENTATIVES) (Any erasures, corrections, or changes -

iais phe Wcdeuafetaty cn atate aad Saas a tektites a

* tf employee is a civil service annuitant (includes U.S. House of Representatives), the gross annual salary shown should include the annuity received by the employee.

et aaa he

RUNS aD TOO STDC LE STDS PODS TIE LOURDES OF RTDEY SCAT HN WUTC OVER UST ON Or WORT ES UES RY SE CT INF, VT wT WENO PES SPEER ES Sat REET OU EE

pe

a

! 4

PAYROLL AUTHORIZATION FORM

(Please Use Typewriter ‘6: U.S. HOUSE OF REPRESENTATIVES( ) (Any erasures, corrections, or changes

or Ballpoint Pen) — ~ ; Washington, D.C. 20515 - on this form must be initialed by the

authorizing official.)
To the Clerk of the House of Representatives: 4 r

| hereby authorize the following payroll action:

. Employee Name (First-Middie-Last) - ~ Effective Date

Donald A. Purdy, Jr. 12/31/78
- Employee Social Security Number Type of Action
. QO ointmen .
2L1-38-9707 Appointment

0 Salary Adjustment
O Title Change

‘El Termination (At close of business on effective date)

Employing Office or Committee/Subeommittee

U1 Leave without pay (Beginning with effective date above and ending |

close of business )

Specify Date

Agssentnationa
(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below.) ~

Position Title Gross Annual Salary *

* If employee is a civil service annuitant (includes U.S. House of Representatives), the gross annual salary shown should include the annuity received by the employee
plus the salary received from the employing office.

(If Committee Employee, complete appropriate item below.)

- 1. O Standing Committee: Staff—O1 Clerical or O1 Professional.

sw . & =
258) Special (Investigative staff of Standing Committee) or Select Committee: Authority—H. Reso? of Congress.

3. 0 Joint Committee.

(If Employee of an Officer of the House, complete item below.)

Position Number __ if applicable, Level_

1 certify that this authorization is not in violation of 5 U.S.C. 3110(b), prohibiting the employment of
relatives.

(Signature of Authorizing Official)

LOUIS STOKES

All appointments and salary adjustments for employees under the House Classification Act and for Committee em-
- ployees, except those of the Committee on Appropriations, the Committee on the Budget; and the Joint Committees, must
be approved by the Committee on House Administration.

APPROVED:

Office of Finance use only:
Office Code. oe nefi

Monthly Annuity $_; 00 as of _ - Payroll

re

| NW 88326 WoT _
| Docld:32244443 Page 4 poo

ere ee La NS Sane SESE SOTNS ESOS SO ESIOEDS SUL SON Seta eet OPO EONS DEL DS SS STENTS STORE ORE OER SORETY crx SOREN SEO AUEEY OPT EP TON [ONE UIE TOL SON PD- Fir 7R WNT COE TREET LEE T TREN NS TEESE TI SEES Te SENOS OPE RT SOnS RE at Pa

tae Pore

pti a

7 Ss ~ _ > = - - : “4
Employee Name (First-Middle-Last). Effective Date 4
; a
Donalé A. Purdy, Jr. March 1, 1978 7
, Employee Social Security Number : Type of Action 3
2113887 OF O Appointment 4
gbdpSalary Adjustment : F
Employing Office or Committee/Subcommittee | O Title Change . “5
. C1 Termination (At close of business on effective date) . he
; 4
Besessinations C Leave without pay (Beginning with effective date above and ending | | “3
close of business.._§ = = ) _
. Specify Date -
a 2
(If type of action is.an Appointment, Salary Adjustment, or.Title Change, complete.appropriate information below.) -. -« a
| : Position Title . Gross Annual Salary* ; a
Stalf Counsel 930,960 |
+ * If employee isa civil service annuitant (includes U.S. House of Representatives), the gross annual. salary shown should include the annuity received by the employee oy “
plus the salary received from the employing office. . co, 8
(If Committee Employee, complete appropriate item below.) :
: ‘}
1. O Standing Committee: Staff—O Clerical or 0 Professional.
2. Special (Investigative staff of Standing Committee) or Select Committee: Authority—H. Res._.2 Sof 223S!Congress. :
3. O Joint Committee..
(If Employee of an Officer of the House, complete. item below.) :
Position Number_______ If applicable, Level. Step. a
certify that this authorization. isnot in. violation of. 5 U.S.C. 3110(b), prohibiting the ‘employment of. an
relatives. at ety ne
Date, March 14, 0000, 19.78 ail
, ; ; a ad . ‘(Signature of Authorizing Official) :
fu" YGUIS STORES
(if appropriate, signature of Subcommittee Chairman or Ranking Minority. Member) gs (Type or print name-of Authorizing Official). =—SSSSCS~CS i
. « Chairman :
(Type or print name and fitle of above official) f+ ffitle“If Member, DistrictandStote) StS ~ 4
_ All appointments -and salary adjustments for employees under the House :Classification Act and for Committee em-
.ployees, except those of the Committee on-Appropriations, the Committee on the Budget, and the Joint Committees, must -- ee
be approved by the Committee on House Administration. 4
APPROVED:._-.. _ 3
Chairman, Committee on House Administration f
| Office of Finance use only: 4

~ (Please Use Typewriter U.S. HOUSE OF REPRESENTATIVES ‘Any erasures, corrections, or changes. |
or Ballpoint Pen) Washington, D.C. 20515 =n this form must be initialed by the

authorizing official.)

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action:

Office Code

Ww

Monthly Annuity $

; {Revised: August 1, 1977)
Copy: for’ Initiating Office or Committee’ oe 5

te et ene a en - a a ee

88326 | ee

rochd:32244443 Page 5


PAYROLL ‘AUTHORIZATION FORM

_ (Please Use Typewriter. U. S. HOUSE OF REPRESENTATIVES - » Any erasures, corrections, or changes

oF ‘Ballpoint Pen) - oO . - Washington, D.C. 20515. -- this form must be initialed by the _—

authorizing official.)
To the Clerk of the House of Representatives:
| hereby outhorize the following payroll action:
___Employee Name (First-Middle-Last) ; = ____ Effective Date
Gani ald A, Purdy, dP. December 1, 1977

Employee Social Security Number 2 . Type of Action | :

aie: 1-38-9707 Oo Appointment

Bes} Salary Adjustment
Employing Office or Committee/Subcommittee - 0 Title Change
ee, ; C1 Termination (At close of business on effective date)
; Assassinati BRS (2 Leave without pay (Beginning with effective date above and ending

close of business

Specify Date
-. (If type of action is an Appointment,-Salary Adjustment, or Title Change, complete appropriate information below.)

Position Title . Gross Annual Salary*

| Stare COURSES }

* if employee i is-a civil service annuitant (includes U.S. House of Representatives), the gross annual salary.shown should: include the annuity received by the employee «
plus the salary received ‘from the employing office. |

(If Committee Employee, complete appropriate item below.)
1 Stoning Committee: Staff—O] Clerical or (1) Professional.: ~

2.2E1 Special (Investigative staff of Standing Committee) or Select Committee: Authority—H. Res 285 _5 | 25 Bsnron
3. O Joint Committee.

(If Employee of an Officer of the House, complete item below.)

* Position Number If applicable, Level

relatives.

Date_ -_ Bacar bd wer do 19.77 -

if appropriate, signature of Subcommittee Chairman or Ranking Minority Member). ; (Type or print name of Authorizing Official)
a t Thai FRAR

“(Type or print name and title of above official) a (Title - if Member, District and State)

All appointments and salary adjustments for-employees under.the House Classification Act and for Committee em-

ployees, except those of the Committee on. Appropriations, the Committee on the Budget, and the Joint Committees, must ~

be approved by the Committee on House Administration.

APPROVED:

Chairman, Committee on House Administration

Office of Finance use only:
Office Code

(Revised: August 1, 1977)

i
t

wy . _ : : , , ; ~ a .
| Nw 88326 | pt po

Dochd:37244443 Page 6

| ‘certify, that this. authorization is not in -violation of 5. USC... 3110(b), Prohibiting the employment of -

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PAYROLL. AUTHORIZATION. FORM.

(Please Use Typewriter... - Uv. Ss. HOUSE OF REPRESENTATIVES: > (Any erasures, corrections, or changes © -

~ or Ballpoint Pen) Washington, D.C. 20515 son this form must be initialed by the.

- To the Clerk. of the House of Representatives:

| hereby authorize the following payroll action:

__ Employee Name (First-Middle-Last) -- = -|--°-—. Effective Date’. - |
— - — a - = \
Donald A. Purdy, Jr. «B/S TF

wee ER i nate a EE a eR a ER ae neta tees NE ES bt ce a

; Type of Action -

Employee Social Security Number
21 4-38-9707

O Appointment .

Employing Office or Committee A Salary Adjustment =

om

EODin Saw es aot oe ee
_

Assassinations [J Termination (At close of business on-effective dote)
:
(If type of action is an Appointment or Salary ‘Adjustment, complete the following. information.) j
7 er
Position Title Gross Annual Salary |
Staff Couneal 24,000 :

. (If Committee Employee, complete apprapriate item below.)

1. LJ Standing Committee: Staff—[_] Clerical or {_] Professional. -
2. [A] Special or Select Committee: Authority—H. Res._ 465 __of -S5¢h Congress. « -

3. [| Joint Committee. .

(If. Employee of an Officer of the House, complete item below.) “ons oe wet

oN ie

Position. Number__.__- : _lf applicable, Level_

f. certify. -that this. ‘authorization: is--not in violation of -5 U.S.C. “3M 00), ‘prohibiting. the: employment co) are

relatives. et cat <n poet
Aug ust 2 _
Date. Wana ee Tee
pe : a“ i (Signature of Authorizing Official)
LOUIS STOKES
aye nna eres print nome of Authorizing Officia) StS
CHAIRMAN

Tigo Member, Diswictand Stole)

on 2» All. appointments and salary adjustments for.employees: under-+the: House: Classification: Act-and: for .Committee:em- <5 +5

:-« :ployees;: except: those. of sthe Committee on Appropriations, the. Committee .on -the- Budget, :and-the Joint-Committeés, -must.~.
be approved by: the Committee on-House Administration. «sees cn ties oe et oe .

_ APPROVED:

t

RSE re Sow CPOE Ens LCT NEALS REDS RET EO CRD DTT TEL Oe TINSEL TF BRST) HOD ORM OL POPE TRE TL COWS a ORO TV RES COTTE UO TESY OT OOO OTIS aL UPL TENT ITR CNN CRR SLES TPE EDA ae PTE ERED E NCIS Teh SE Ee TYCO TERE SERS VOLE CNT SPSS CON LTT SESS

-Chairman, Committee on House. Administration -*

+ Office of Finance-use only:. -

Office Code.


PAYROLL AUTHORIZATION FORM

(Please Use Typewriter. -- -U.S. HOUSE OF REPRESENTATIVES (Any erasures, corrections, or changes = 3

. : on this form must. be initialed by the
or Ballpoint Pen) Washington, D.C. 20515 . authorizing official.)

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action:

Employee Name (First-Middle-Last) == Ne ; — | Effective Date.

—— ; i
Donald A. Purdy, dr. | | |
Employee Social Security Number -——- a Type of Action \

2b) 38 9707

(_) Appointment

Employing Office or Committee __| 1 Solory Adjustment

LJ Termination {At close of business on effective date)

Assassinations

(If type of action is an Appointment or Salary Adjustment, complete the following information.) .°

. Position Title | 7 Gross Annual Salary )

$18,000

(If Committee Employee, complete appropriate item below.)

1. J Standing Committee: Staff—[_] Clerical or [-] Professional.

2. [4] Special or Select Committee: Authcrity —H. Res. 465 of 20th ‘Congress.
3. [] Joint Committee.

(If. Employee of an Officer of the House, complete.itém'below.)) >

- Position Number If applicable, Level

EMobile MAC Sad Salad tea AL We tat te A el cast EO Su ooo
.
_

-L-certify that this: authorization is not in violation of -5. US.C. _3110(b), . prohibiting the.employment ‘of -

relatives.
Date_____-- May 10 19 ae — : 4
; , (Signature of Authorizing Official a
at Louis Stokes a
a a _ (Type or print name of Authorizing Official) : 4
oo Sharman _
oe" (Title-if Member, District and State) . : r

-. All-appointments. and salary: adjustments ‘for‘employees under the House. ‘Classification. Act‘and for Comniitteé em-'
. ployees, except::those of the Gammittee ‘on. Appropriations, the’ Committee: on-the’-Budget, ‘and the: Joint: Committees, must -
be approved by the Committee on House Administration. “0200 0 oe a ee aa ee :

. APPROVED:

Chairman, Committee on House “Administration”

Office of Finance use only:.. >. :.

Office Code


PAYROLL AUTHORIZATION. FORM= oe ee

-.°(Pléasé Use Typewriter... -« U.S.- HOUSE OF : REPRESENTATIVES: . (Any-erasures,.corrections, or changes~.

Washington, D.C. 20515 - . -on this form must. be initialed by Ane

or Ballpoint Pen) authorizing official.)

~ To. the Clerk:of the-House of Representatives: oa

| hereby authorize the following payroll action:

_Employee Name (First- -Middle- Last) rd Pee _ on Effective Date...

Donald A. Purdy, dr. | AYWTT
_ Employee Social Security Number “tetas | _ Type of Action
211 338 9707 7) Appointment
Employing Office or Committee — - | s Salary Adjustment .
LJ Termination.(At close of business on effective date)

Assassinations

(If type-of action is an Appointment or Salary Adjustment, complete the following information.)

‘Position Title Sf. Gross Annual Salary

$38,200

(If Committee Employee, complete appropriate item: below.)

1. EJ Standing. Committee: Staff—[_] Clerical or {_] Professional.
2.) A. Special or Select Committee: Authority—H. Res... $65 of _35€N Congress. oo

3: o Joint Committee.

(If Employee of an Officer of the House, complete item below.) 2 00. 0 0 7 mo aod
Position Number_____ ve Iapplicable; Level Step__ 2.
Lb: certify that. this: -authorization:.is ‘not :-in ~ violation. -of: ‘5. USC. 23M 0b), Prohibiting the ‘employment of:
relatives. . * e . oe
Date April 28. 19 77 ;
I ee ad a (Signature of Authorizing Official)

4 ‘Louis Stokes

(Type or print name of Authorizing Official) «

a
“ Chairman _

~All appointments and-salary adjustments:for employees. under the House Classification Act and. for Committee.em- |:
ve ployees; except those ofthe: Gommittee on: Appropriations, the. Committee.:on the, Budget;.and: the Joint: Committees;-must

be approved by.the Committee on, House Administration.

. APPROVED:

. cee _ a o— mo —_ ere ae . Chairmen, Committee-on House Administration:

Office of Finance use on

Office Code.

Copy for Initiating Office or Committee

W 88326 Bm aa —-

ii:37244443 Page 9

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’ PAYROLL- AUTHORIZATION. FORM =. ee te ; :
-- (Please Use Typewriter... ~~. U.S: HOUSE. OF REPRESENTATIVES - . ont form mow be nated ye “rod
Wood yo: ; _on this u Lo
or Ballpoint Pen) a _ ‘Washington, D.C: 20515 authorizing official.)
-To the Clerk of the House of Representatives:
| hereby authorize the following payroll action: . .-
7 Employee Name. (First- -Middle- “Last) vee 7 “ . : a oe —_ Effective Date
Donald A. Purdy, dr. . 2-|-77
. - _ Employee Social Security Number Type of Action @ =»
217-38-9707 (1) Appointment
Employing Office or Committee _ a Salary Adjustment
Sel ect Committee on Assassi inations [] Termination (At close of business on effective date)

(If type of action is an Appointment or Salary Adjustment, complete the following information.) ©
Position Title oe . Gross Annual Salary _

(If Committee Employee, complete appropriate item below.)

1. O Standing Committee: Staff—{_] Clerical or‘{_] Professional.

2. PSpecial or. Select Committee:-Authority —H. Res__-h). of 35 Congress.
3. [-] Joint Committee...

(If Employee of an Officer. of the House;.complete item.below,) «. -

. Position Number_____. if applicable; Level__ +.

os ok certify: that. this «authorization: is not-.in= violation of 5 USC. *31.10(b),. prohibiting the employment of - .+

relatives.
2-28-77
Date.__- eee sh SPENSER URI: TOF TT Out Rete co
oa : . Henry Bg. Gonos Sig ve g e of Authorizing Official)
Chal - 3 A lvpeer worcocpeascs Official)
pe eee ee ee ee —  -ad
 (Title—If Member, District and Stote}, .-. .. -
tins a Al:appointments and salary. adjustments: ‘for-employees under the House -Classifieation:.Act:-and. -for:-Committee: em- af
Shs “ployees, except those.of the Committee on Appropriations, the Gommittee -on the - Budget, cand, the:Joint.Committees; must. ~.
be approved by.the Committee on House Administration:. wr eR a EO a Nan er
_ APPROVED: Dip Ene panne eee ene een _

~ Chairman, Committee on House Administration: -

Office-of Finance use only:-:

Office Code

Copy for Initiating Office or Committee

i - _ _ Sanne _
; NW 88326 ee [— ~

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PAYROLL _ AUTHORIZATION NN FORM :
(Please. Use Typewriter | :

o To the Clerk of the House of Representatives:

_ a hereby outhotize the following payroll action:

7 “Employes Name ( First Middle-Last) =

US. “HOUSE | OF EPRESENTATES.
or Ballpoint Pen) nee

- “GPO : 1975 O'--57+255

Washington, D.C. 20515:

on this form must be initialed by the:
nn authorizing official.) :

~ Effective Date
"Type of Action.
Di Appointment -
cs Salary Adjustment -

o Termination (At close of business ‘on n effective date) -

Chairman, Conimittee on House Adminisrotion,

‘ ee

“Committee

: (Any erasures, corrections, or changes


mE ~~ «(Please Use Typewriter AL JU. S. ‘HOUSE. OF- REPRESENTATIVES. A ; (Any erasures, corrections,.or changes

‘ PAYROLL AUTHORIZATION FORM: ~ | : oe

‘or Ballpoint Pen) = “Washington, DC.20518 8s an this form must be initiated by the
To the Clerk of the House of Representatives: . 3
| hereby authorize the following payroll action: : ‘
: eames Name (First-Middle-Last) a Effective Date 7
—— — - -
. if isi? .
~ - \
Employee Social Security Number . - TL Type of Action i
- - a {
- .. _ . \
21135 9797 ____| Ei Appointment
Employing Office or Committee. ~~ 40 Solary Adjustment . |
. , a .
Saleet Come tise on Assassinai eloné A Termination (At close, of business on effective date)

__ (If Committee Employee, complete appropriate item below.) . .
‘a Standing Committee: Staff—[_] Clerical or] Professional. oe oy , \ ;
. . ~ \
2. |] Special | or: Select Committee: Authority H. Res $94 of AE HEN Congress. \
,
3. L] Joint Committee.
(If Employee of an Officer of the House, complete item below.) : ‘ : HS!
Position Number__-- If opplicable ‘Level _ee ee! Step.
/ = ecl-certify- that - this. authorization is not ‘in violation of 5 US. C 3] 10). prohibiting: the .employment of »
relotives ;
Date December oF we
/ _ : (Signature of Authorizing Official) ~ ~
: ho Thomas N. Dowsing, Chairman
“ ; . (Type or print nome of Authorizing Official) — ‘|
SO Select Coematttes on Assassinecions
~ _ ~ . ~ " (TitleIf Member, DistrictandStote) = SSsStS~S~S ~
* eS a ’
. All appointments and salary adjustments for employees. under.:the- House ‘Classification: Act-and for‘Committee’em:\ 4 A
" ployees; except those of the Committee on Appropriations, the: -Committee on the Budget;and the Joint: Committees; ‘musts: 9 \
be approved by the Committee on House Administration. Sc FS : . ; - \
u ° . t. '
_ APPROVED:._. | _
| Office of Finance use only:
Office Code


PAYROLL AUTHORIZATION FORM. ; ~ Oe

or Ballpoint Pen) | Washington, D.C. 20515 staerleg ao be initialed by the

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action: ~

Effective Date

(Please Use Typewriter- \__. US. HOUSE OF REPRESENTATIVES - (Any erasures, corrections, or changes

December 1, 1976

Type of Action

OO Appointment

oO Salary “Adjustment

(1 Termination (At close of business on effective date]

act Coumittee: on Assassinations aa

(If Committee Employee, complete appropriate item below.)

h,
| Standing Committee: Staff— —— Clerical or[_]Professional. . wl .
(2 ££] Special or Select Committee: Authority—H. Res. t549 PEER Congress, . | JI
; i \y
3. LJ Joint Committee, _ a ; . 4 he \
. Le ’ , F

(If Employee of an Officer of the House, complete item below.)
—— /
; Position’ Number Woo If applicable, Level_ oe . Step_.

| certify that this authorization is not in violation. of § U.S.C. 3110(b), prohibiting the employment of

relatives. Le .
: Rep P? G ,
Dote..._ Havember 220 98 Co
ae . (Signature of Authorizing Official)
~ ‘ . Thomas N. Sewing, Chaiyran
( (Type or print name of Authorizing Official) ==SSSSOS™S*~S~S~S

Select Comm ni ttee on As sass inations .

All appointments and salary adjustments for employees under the House Classification Act and for Committee. em--

-. ployees; except-those of the Committee on Appropriations, the Committee: on the: Budget, and: the Joint: Committees, must. °

be approved by the Committee on House Administration. : NS

APPROVED: ____

| Office of Finance use e only: .

Office Code._

_ Copy for Initiating Office or Committee:
n

| W 88326 ae
| Docld:32244443 Page 13 | .

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ee

MEMORANDUM

. ——- oe a es a
~  TO:. ALL Staff Employees — oe eee rs oo
FROM: Budget Officer
DATE: January 3, 1977 |
—- RE: - Payroll Certification |
‘Starting with the January, 1977 payroll, the certification |
to the House Finance Office requires, among other things, the
-relationship, if any, of each staff employee to any current
Member (Of Congress (those taking office January 3, 1977). |
“phe following are the relationships to be included ‘ands
“the certification: . _ .
father —— ee chew a brother-in-law : |
_-mother. = i siecle | sister-in-law \
- son husband =. stepfather abe \
"daughter - wife _ -. -) stepmother. ~~ | |
“, brother .-* father-inlaw == ss stepbrother - '
cs Sister oe mother-in-law = = sss stepsister a |
'unce = son-in-law shaallf-brother © | ne
aunt : daughter-in-law ..  . ~——_—__— half-sister
first cousin oS . . : |
. All staff employees are ‘requested to complete this
. form and return it ‘to the ‘Budget officer.
“Approved |
Richard A. ‘Sprague
oe
' A
ce in sae ee eins eee ees ree ener es cere ees meee eee eee cree eee ces me ees em ee es eS rue ores SO Re ORD OS tm CU GES em MRS GD Oy tein GUE amie SS Gee Sete Gee Se ey eS ce ee ee ee ee ee is SY eS ee oe |
‘I am not related _. FO |
a am ‘related by the fro 1owing relationship | |

88326 FO ee
Twas Page 14 | : a! }

